Risk factors and outcomes of patients with BSI due to Acinetobacter baumannii-calcoaceticus

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“A total of 245 case-patients were matched with 245 control-patients. Independent risk factors associated with BSI due to ABC included Charlson’s comorbidity score≥3 (OR= 2.34, p= 0.001), direct admission from other health-care facilities (OR= 4.63, p< 0.0001), prior hospitalization (OR= 3.11, p< 0.0001), presence of an indwelling central venous line (OR= 2.75, p= 0.011 ), receipt of total parentral nutrition (OR= 21.2, p< 0.0001), prior receipt of β-lactams (OR= 3.58, p< 0.0001), prior receipt of carbapenems (OR= 3.18, p= 0.006), and prior receipt of chemotherapy (OR= 15.42, p< 0.0001).” Chopra et al (2014).

Reference:

Chopra, T., Marchaim, D., Johnson, P.C., Awali, R.A., Doshi, H., Chalana, I., Davis, N., Zhao, J.J., Pogue, J.M., Parmar, S. and Kaye, K.S. (2014) Risk Factors and Outcomes of Patients with Bloodstream Infection (BSI) due to Acinetobacter baumannii-calcoaceticus Complex (ABC). Antimicrobial Agents and Chemotherapy. June 2nd. [epub ahead of print].

Abstract:

Identifying patients at risk for bloodstream infection (BSI) due to Acinetobacter baumannii-calcoaceticus complex (ABC) and providing early appropriate therapy is critical in improving patients’ outcomes. A retrospective matched case-control study was conducted to investigate the risk factors of BSI due to ABC in patients admitted to the Detroit Medical Center (DMC) between January 2006 and April 2009. Cases were patients with BSI due to ABC; controls were patients not infected with ABC. Potential risk factors were collected 30 days prior to ABC positive culture date for the cases and 30 days prior to admission for the controls. A total of 245 case-patients were matched with 245 control-patients. Independent risk factors associated with BSI due to ABC included Charlson’s comorbidity score≥3 (OR= 2.34, p= 0.001), direct admission from other health-care facilities (OR= 4.63, p< 0.0001), prior hospitalization (OR= 3.11, p< 0.0001), presence of an indwelling central venous line (OR= 2.75, p= 0.011 ), receipt of total parentral nutrition (OR= 21.2, p< 0.0001), prior receipt of β-lactams (OR= 3.58, p< 0.0001), prior receipt of carbapenems (OR= 3.18, p= 0.006), and prior receipt of chemotherapy (OR= 15.42, p< 0.0001). The median duration from ABC positive culture date to initiation of appropriate antimicrobial therapy was 2 days (Interquartile range, IQR [1 – 3]). In-hospital mortality was significantly higher among case patients compared to control patients (OR= 3.40, p< 0.0001). BSIs due to ABC are more common among critically ill and debilitated institutionalized patients, who are heavily exposed to health-care settings and invasive devices.

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